Taffy Live Parental Consent Form

Please print out this form and fax the signed form to us at 1-818-999-0172.

I give permission for my child ___________________________ to participate in all activities on the taffylive.com site, including receiving announcements such as password retrieval, sending and receiving Taffy Live email, participation in contests and sweepstakes, and posting on and viewing of the Taffy Live forums. My child is also permitted to sign up with other Taffy Live sponsors, who help keep Taffy Live free for our members.

My child’s current email address is: _________________________________________

I have read the Taffy Live Privacy Policy, which provides that Taffy Live will never share my child’s personally identifying information with any third parties. I understand that I can remove my permission with written notice, at any time. I have also read the Taffy Live legal/privacy policy available @ http://www.taffylive.com.

Child’s Login Name: _________________________________ (PLEASE WRITE CLEARLY)

Child’s Birthdate: ________________________________________________________

Parent/Guardian Name: ___________________________________________________

Parent/Guardian Signature: _________________________________________________

Relationship to Child: _____________________________________________________

Date: ________/__________/_________

Please enter your e-mail address in case we need to reach you: _____________________

Please print out this form and fax it to us at 1-818-999-0172.

Or by mail to: Taffy Entertainment

Attention: Delphine Pham

20335 Ventura Boulevard, Suite 225

Woodland Hills, California 91364

*If you have any questions regarding the Taffy Live site or would like to speak with us concerning the sign up process please use this form.